The first few years of life are crucial for the developing child. Many new skills and experiences shape the trajectory of development during the lifespan. It is for this reason that any disruption or deviation from normal development needs to be taken seriously.
There are many early signs of autism that can be missed. This is not to say that we need to over-diagnose or attach a label to every child with delayed development. There are many causes of developmental delay. Autism is just one of them.
The important thing is to be vigilant of possible signs and to seek early medical attention if your child exhibits these features.
Remember that there is a very wide range of what is considered normal, so over-analysing every single developmental milestone is neither productive nor beneficial to a child. Taking one sign in isolation is also not a correct approach. The gestalt or overview is more important and how all the signs ‘fit together’ is what is more crucial. The child as a whole is not to be forgotten.
The following summarise the early red flags for autism and the accompanying text is to clarify the meaning of the terms used:
- No babbling at all
- Absence of any meaningful words
- Does not understand simple instructions
Sosial & Behaviour
- Does not respond to his/her name
- No interest in parent(s)/caregiver(s), does not react when they leave
- Poor/reduced eye contact
- No/limited gestures
- Tendecy to initiate interaction only to get something
- Pulls other people’s hands to get things but does not look at them
- Does not point
- Does not look where you point
Play & Level of Understanding
- Minimal/no exploratory play
- Uses objects or toys in repetitive ways
Movement & Hand Skills
- May/may not be delayed
These are words that are used to convey a message. If your child utters a word that is comprehensible by others, but does so in a mechanical way or in a way that does not convey any meaning, it cannot be considered a meaningful word.
Conversely, if your child says a word, but his/her pronunciation is slightly unclear, it still counts as a meaningful word provided it is used to mean something.
An example is ‘mama’; if the child says ‘mama’ in a non specific way and utters it without a clear meaning; it is not considered a meaningful word. Another example is calling everyone ‘mama’, which means it does not convey a specific meaning. However, if the child says ‘no’, but pronounces it as ‘na’, it is a meaningful word if he/she uses it consistently and correctly to mean ‘no’.
This is particularly important for children with autism, as they are often reported to ‘say many words. But, when further details are elicited, they may just say the words in a non-specific way or without comprehension.
Quite often parents report that their children with autism seem to have had normal language development and then ‘suddenly stopped talking. When you see a doctor, he/she will need to determine whether there were meaningful words which your child lost over time, or whether his/her seemingly meaningful words were actually used without context or understanding. Both scenarios can be seen in autism. Also, subtle abnormalities in language may not be immediately apparent until a full interview is done to ascertain the developmental milestones of your child.
The Final Word
Whatever the outcome, try not to view a diagnosis of autism as a tragedy. “Your child is the same adorable, charming, curious, funny, precious little treasure the day after you hear a diagnosis as they were the day before,” says Marsh. “You know who your child is, and that has not changed. The purpose of a diagnosis is not to put a ceiling or close a door on what your child may accomplish. Don’t let anyone tell you otherwise or warn you against letting your child be ‘labeled.’”
A diagnosis of autism might be scary, but it’s the first step toward getting your child the support they need to live a fulfilling life on their terms — and the support you need to help them live that life. If your child does have autism, a diagnosis is the best thing that can happen to them.
- AUTISM IN SHORT: A Handbook for Parents, Dr. Subhashini Jayanath, Gerakbudaya Enterprise, Petaling Jaya, 2019.